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Showing 4 results for Plastic Surgery
Tissue expander, a modality in the treatment of burn induced deformities: A 6-year study of patients with burn deformities admitted to Plastic Surgery Department of Imam Hospital
Mr Farah Vash. ,
Volume 58, Issue 1 (4-2000)
Abstract
Use of tissue expander in the recent decade has revolutionized the plastic surgery. The tissue expansion technique is advantageous in body reconstruction because it makes it possible to resurface the defects resulting from excision of burn scars with neighboring skin similar in color and texture and superior to skin grafts or distant flaps. Treatment of burn alopecia was a major problem in the past, but with the application of tissue expander this deformity is treated. We have learned by experience that tissue expander should not be used in the limbs, because of the high risk of complications. The best locations for tissue expander are in order: Scalp, face, neck and trunk. The incidence of burn induced deformities in Iran is high. In this research, I analyze the use of TE in 130 patients with burn deformities. The variables studied were: Sex of patients (43.1% male, 56.9% female), age groups, level of education, occupation, the anatomical site of burn, extension of burn, volume of tissue expansion, the location of placing the TE and complications.
The cosmetic results after oncoplastic breast surgery in Iranian women
Kaviani A, Taslimi Sh, Athari B, Yunesian M, Hosseini M, Rabbani A,
Volume 68, Issue 4 (7-2010)
Abstract

Background: The oncoplastic surgery has been revolutionized breast conservative surgery. The aim of our study was to represent the cosmetic outcome of oncoplastic breast surgery in Iran and to evaluate its determinants.

Methods: Fifty eight patients with unilateral breast neoplasm operated with single surgeon in Imam Khomeini Hospital, Tehran, Iran. Three view photographs were obtained pre and post operatively and were put in separate PowerPoint slides. The photographs were evaluated by six health related professionals. They scored the cosmetic outcome with modified questionnaire containing general and specific questions. Weighted kappa used for intra and inters rater reliability and ANOVA was used for analyzing cosmetic outcome determinants.

Results: Generally, 72.2% of the photographs got the excellent or good score in a single breast evaluation part. Its items breast size, nipple deviation and scar quality scored 94.2, 67.9 and 88.8 respectively. "In comparison with contra-lateral breast" part shape asymmetry, need for surgery of contra lateral breast and size asymmetry scored 68.9, 75.8 and 69% respectively. Tumor size greater than two cm had poorer outcome (p=0.039) upper outer quadrant tumor had the worst and upper inner quadrant tumors had the best outcomes (p<0.0001). Patient with 50 to 60 years of age had the poorest outcomes (p<0.0001). Weighted kappa for inter and intra rater kappa was 0.12 and 0.58 respectively.

Conclusions: Acceptable cosmetic outcome is obtained in the first experience of oncoplastic breast surgery in Iran. Long term monitoring of oncologic and cosmetic outcomes in greater numbers of patients is recommended.
The outcome of free-flap reconstructive surgery for tissue defects following head and neck surgeries: a report of 29 cases
Fathi Hr, Fathi M, Harirchi I, Tavangar K,
Volume 69, Issue 1 (4-2011)
Abstract
Background: Reconstruction by free tissue transfer and microvascular anastomosis can provide a reliable repair for tissue defects in head and neck surgeries. During this study, we evaluated the clinical characteristics and outcomes of reconstructive surgery by the use of free flaps for defects resulting from head and neck cancers. Methods: This quasi-experimental study included 29 patients having been diagnosed with head and neck cancers and referred to the Plastic Surgery Clinic and Cancer Institute of Imam Khomeini Hospital Complex in Tehran, Iran, for the resection of cancerous tissue. After operation, the patients were followed-up for three months and the surgical outcomes were evaluated. Results: The mean age of participants was 50.8 ± 15.1 yrs. Two patients (6.9%) had total and three (10.3%) had partial flap loss. The rate of total and partial flap loss in this study was less than 10%. There were no differences between groups with total and partial flap loss regarding mean age, mean operation time, and mean perioperative ischemia time. Prothrombin time (PT) and international normalized ratio (INR) were significantly different in patients with total flap loss compared with patients with successful reconstruction. The INR for the group with total loss was 2.2 and 1.2 ± 0.3 for other patients (P=0.0006). The mean ACT was 46 seconds in patients with total flap loss and 82 ± 18.9 seconds for other patients (P=0.08). Conclusion: Considering its high success rate, free tissue transfer can be considered as a method for single-stage reconstruction in almost all major head and neck defects.
Management of cosmetic surgery in iran: challenges and solutions
Maryam Tajvar, Parisa Pourfarokh, Najmeh Bahmanziari, Ebrahim Jaafaripooyan, Maryam Nazari , Haniye Sadat Sajadi ,
Volume 81, Issue 1 (4-2023)
Abstract
Background: Nowadays, beauty practices have attracted the attention of people following the change in lifestyle and social values. Therefore, the present study was conducted with the aim of examining the opinion of experts regarding the challenges and management solutions of the aforementioned practices in Iran.
Methods: This qualitative study was conducted through interviews with 26 policymakers and cosmetic surgery service providers in Tehran from April to September 2022. Sampling was purposeful and snowball. The interviews were semi-structured and thematic analysis was used to analyze the data obtained from the interviews. The inclusion criteria for the interviewees' entry were knowledge and experience in the subject and willingness to participate.
Results: Challenges under the four categories of service providers (improper education, non-specialist providers, moral hazards, deficiencies in the way laws are written, and the ineffectiveness of the complaint handling process), service receivers (being influenced by deceptive advertisements, low level of public health literacy and lack of mental health), the place of providing services (performing surgeries in non-standard places and non-integrated information system) and medicines, products and medical equipment (insufficient control over supply, distribution and use and price fluctuations) were categorized. Experts considered the major part of the challenges to be related to the service providers. In the category of service recipients, "being influenced by deceptive advertisements" was the main problem mentioned by the experts. Performing surgeries in non-standard places, including limited surgery centers, non-sterile places, and unauthorized places, is among the unsolved problems regarding the place of providing services. In relation to medicines, products, and medical equipment, the main problem was insufficient supply, distribution, and use supervision.
Conclusion: The main effective measure to solve the challenges is to strengthen the supervision of the health system administrator with internal and external coordination and cooperation. In this regard, it is recommended to develop educational, ethical, and legal frameworks, regulate regulatory laws, public awareness, clinical interviews and psychological counseling, especially before cosmetic surgery, and the establishment of an integrated electronic health record system.

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